MEDICARE: SPEECH THERAPY THAT WORKS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	252Y00000X	Early Intervention Provider Agency	017595	NY

General Provider Information

NPI Number	:	1245506948
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPEECH THERAPY THAT WORKS

Provider Business Mailing Address
First Line	:	22409 64TH AVE
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11364-2326
Country	:	US
Telephone Number	:	917-687-9322
Fax Number	:	347-235-4126

Provider Business Practice Location Address
First Line	:	22409 64TH AVE
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11364-2326
Country	:	US
Telephone Number	:	917-687-9322
Fax Number	:	347-235-4126

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MISS YELENA ALKOVA
Credential	:
Telephone Number	:	917-687-9322

Provider Enumeration Date	:	03/27/2012
Last Update Date	:	03/27/2012

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Directions to “SPEECH THERAPY THAT WORKS ” Practice Location

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